Joyce has a hard time holding a train of thought or finishing a sentence. But when Patsy Cline's "Crazy" filters through the speakers at the Carson Valley Adult Day Club, a smile lights up her face and the words to the song pour out of her mouth.

The Carson Valley Adult Day Club opened in November at the Douglas County Community & Senior Center in Gardnerville to provide a place for adults with cognitive or physical disabilities to spend the day and to offer family members a break from caregiving.

"We're adding routine to their life that they're looking forward to," said Emily Buntin, the club's director. "I like providing the resources to both the family and the client. The family deserves to have a break and the client deserves to have a social life."

There are 19 adult day care centers in Nevada, Buntin said, but just four are in Northern Nevada. One is in Sparks, two are in Reno, and the Carson Valley club, the only rural program in the state, is the fourth, Buntin said.

The Carson Valley club offers snacks, paid showers, activities, exercises and stretching to 17 clients, the majority who are in their late 80s. Four clients are older than 90.

"Cognitive issues are what we deal with the most here," Buntin said.

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On a recent Wednesday, clients played video games, using a controller to mimic paddling a canoe and shooting a basketball.

"You can have my wrist, but no marriage now," Seth, a client, joked with a smile as he held his arm out to recreation specialist Autumn Fenzke so she could strap a controller to his wrist. "If I'm not back in eight days, mind the clock."

When Seth's turn was over he relinquished the controller to another client and cheered her on by singing "Row, row, row your boat" and "Rolling on the river."

Clients don't have to be Douglas County residents to attend the program, but do have to undergo an assessment and interview. The center is licensed to serve up to 20 clients at a time.

There are four full-time employees at the center; the goal is to have one employee per half-dozen clients. The center currently operates as a social model, but the goal is to become a medical model that can accept Medicaid and to have a licensed nurse on-site to distribute medication, Buntin said.

"We take care of our families. Giving caregivers respite, the time that they need to take care of themselves," Buntin said. "The program allows families to keep their loved ones at home … This is a lot cheaper than paying $4,000-$12,000 for long-term care."

The program costs $45 for up to five hours and $70 for more than five hours. Scholarships are also available to some low-income families.

"We've had quite a few successes. Families are acknowledging the breaks they're getting and our clients are making friends," Buntin said.